Note: Descriptions are shown in the official language in which they were submitted.
CA 02920349 2016-02-03
WO 2015/021442 PCT/US2014/050440
REMOTE PHARMACEUTICAL VERIFICATION
BACKGROUND
[0001] This invention relates generally to verification of filled
pharmaceutical
prescriptions, and more specifically to verification of filled pharmaceutical
prescriptions
remotely from the location where the prescription is filled.
[0002] Pharmaceutical prescriptions are ordered by medical practitioners to
designate
specific pills and other medicines for a patient. The medical practitioner
typically writes the
prescription, either by hand or electronically, and the prescription is
transmitted to the
pharmacy. At the pharmacy, the prescription is filled and a pharmacist on-site
physically
verifies that the prescription written by the medical practitioner matches the
pills actually
dispensed into a vial or other container. To verify the pills, the pharmacist
reviews a label on
the vial and reviews the pills actually dispensed into the vial. Any errors,
including
dispensing a wrong pill or a labeling error, can be dangerous for a patient.
However, having
a pharmacist on-site at each pharmacy physically reviewing pills is expensive,
significantly
increasing operating costs for a pharmacy, and often prohibiting a pharmacy
from opening in
areas that either lack a pharmacist or financially cannot justify opening a
pharmacy.
SUMMARY
[0003] A pill verification system enables a pharmacist to verify a
prescription at a remote
location separate from the location where the prescription is filled. The pill
verification
system receives a prescription from a medical practitioner. The prescription
is electronically
entered to identify prescription information describing the prescription, such
as particular
pharmaceutical formulations, dosages, and so forth is termed prescription
information. When
the prescription is filled in the pharmacy, a pill verification system
collects verification
information for the pills in the pill vial filled for that prescription. The
verification
information is information sufficient to uniquely identify a pill, for example
images of pills
filling the vial, a machine verification of the pills, spectrometer data, pill
weight, and so forth.
The verification information may include one or more images of each pill in
the pill vial, one
or more images of groups of pills in the pill vial, ora pill verification from
a pill verification
system that verified each pill in the pill vial is consistent with the
prescription information.
Images of an individual pill may include images of the pill from multiple
views, or may
1
CA 2920349 2017-04-18
include an image of a circumferential view of the pill. In addition, label
information including an
image of the label of the filled pill vial or a label verification from a
label verification system, is
captured. In one embodiment, the label information is information for a label
to be printed and
affixed to the pill vial rather than a label already affixed to the pill vial.
The pill verification
system transmits this information (prescription information, verification
information, and label
information) to a pharmacist at a remote verification system for final review
and approval.
[0004] The remote verification system displays this information to the
pharmacist. The
pharmacist reviews the prescription, the verification information, and the
label information to
verify the prescription has been properly filled. The pharmacist in one
embodiment is provided
the label image and images of each pill that filled the prescription. The
pharmacist's verification
is logged by the remote verification system and returned to the pill
verification system where the
prescription is filled. The pill verification system displays the verification
result from the
pharmacist and provides the result to a pharmacy technician. The pill
verification system in one
embodiment securely holds the pill vial until a verification result has been
received. The
pharmacy technician at the pharmacy may then place the verified filled
prescription in a holding
area or may dispense the prescription to the patient.
100051 In one embodiment, the pill verification system incorporates a pill
imaging system
that captures images of pills filling a pill vial, along with a pill vial
imaging system. In this
embodiment, the pill verification system captures images of the pills filling
the vial along with
the image of the pill vial itself, and may perform related verification of the
pills or the pill vial.
The pill verification system in this embodiment provides the prescription,
pill verification
information, and label information to the remote verification system and
displays a verification
result received from the remote verification system.
According to one aspect, there is provided a method for remote verification of
a filled
prescription, the method comprising: receiving prescription information for a
prescription to be
dispensed to a patient; receiving pill verification information from a pill
verification system of at
least one pill filling the prescription, the pill verification information
comprising a plurality of
images of individual pills; displaying the prescription information, the
plurality of images of
individual pills, and the pill verification information on a display, wherein
the display enables a
user to review the plurality of images and the pill verification information;
receiving a response
to the information from an interface, the
2
CA 2920349 2017-04-18
response accepting or rejecting the filled prescription; and transmitting the
response to the
prescription filling location.
According to another aspect, there is provided a method for remote
verification of a filled
prescription, the method comprising: receiving prescription information for a
pharmaceutical
prescription to be dispensed to a patient; receiving pill verification
information from a pill
verification system, the pill verification information describing at least one
pill filling the
pharmaceutical prescription and comprising a plurality of images of individual
pills; transmitting,
to a remote verification system, the prescription information, the plurality
of images of individual
pills, and pill verification information for display to a pharmacist; and
receiving a response from
the remote verification system, the response indicating whether the
prescription is properly filled.
According to yet another aspect, there is provided a non-transitory computer-
readable
medium comprising instructions that when executed by a processor cause the
processor to
perform steps of: receiving prescription information indicating a quantity of
a pharmaceutical
composition for a patient; capturing a plurality of images for each of one or
more pills;
determining, for each pill of the one or more pills, a pill verification
indicating whether the pill
matches the pharmaceutical composition based on the plurality of images for
the pill; identifying
pill vial information including a pill vial image of a pill vial, a
verification of the pill vial image,
or a label to be printed for the pill vial; and transmitting the prescription
information, pill vial
information, and pill verification to a remote verification system.
BRIEF DESCRIPTION OF THE DRAWINGS
[0006] Fig. 1 illustrates a workflow using systems and methods for
verification of pills
according to one embodiment.
[0007] Fig. 2 shows a display for pharmacist review of the filled
prescription order according
to one embodiment.
[0008] Fig. 3 shows an embodiment of a pill verification system separate
from the pill
imaging and pill vial imaging systems.
[0009] Fig. 4 shows components of a verification system according to one
embodiment.
[0010] The figures depict various embodiments of the present invention for
purposes of
illustration only. One skilled in the art will readily recognize from the
following discussion
2a
CA 2920349 2017-04-18
that alternative embodiments of the structures and methods illustrated herein
may be employed
without departing from the principles of the invention described herein.
DETAILED DESCRIPTION
Overview
[0011] Fig. 1 illustrates a workflow using systems and methods for
verification of pills
according to one embodiment. Initially, a pharmacy receives a prescription 100
from a medical
practitioner, such as a doctor or nurse practitioner. The prescription 100 may
be a written
prescription provided by a patient, or the pharmacy may receive the
prescription 100 directly from
the medical practitioner electronically, by fax, by telephone or otherwise.
The prescription 100
specifies various information about a medication to be dispensed to the
patient. Depending on the
particular prescription 100, the prescription may specify a quantity, a
specific pharmaceutical
composition (i.e., one or more specific drugs and/or dosages thereof, a
specific manufacturer),
instructions for the patient to use the prescription, and other details.
[0012] The prescription is brought to or provided electronically to a
pharmacy, where the order
is entered 110. The order may be entered electronically by a medical
practitioner contacting a
pharmacy directly or a pharmacy technician at the pharmacy may enter the order
110. The order is
entered into a pharmaceutical tracking system (not shown) at the pharmacy.
Some systems may
themselves auto-generate an order based on electronic prescription information
received. The
pharmaceutical tracking system may also capture an image of the prescription
if the prescription was
hand-written. The electronically captured information about the prescription
is termed prescription
information, which may include the specific quantity, composition,
instructions, and so forth for the
prescription, and may include an image of the written prescription itself The
pharmaceutical
tracking system stores patient and prescription information and maintains
records of prescriptions
filled at the pharmacy. When the pharmacy fills the prescription, a pharmacy
technician selects a
vial for dispensing the prescription, prints a label for the vial, attaches
the label to the vial, and
obtains the desired pills for the prescription from a stock.
[0013] Prior to filling the prescription and providing a pill vial with
pharmaceuticals to the
patient, the pharmacy technician loads the pills into a pill verification
system 120. The pill can be
any type or shape, including tablets, capsules, etc. The pill verification
system 120 in one
embodiment receives the pills and obtains images of each pill. One example of
a pill verification
3
CA 2920349 2017-04-18
system is described in PCT Pub. No. WO/2011/112606. In one embodiment of a
pill verification
system, pills travel down a chute and images are captured of each pill as it
is moving down the chute
by cameras (e.g., four cameras in one example) at different angles (typically
orthogonal to one
another) to the pill. This captures images of the pill from multiple angles
and allows a view of
many aspects of the pill for verification purposes. In one embodiment of the
pill verification system
120, the pill vial is located at the end of the chute and collects the pills
after the images are captured.
In this embodiment, the pill verification system 120 produces verification
information 140 including
the images of each pill. The verification information 140 includes information
representing each
pill or substantially each of the pills to be added into the vial, and is used
by a pharmacist to
determine whether the pill vial is filled with the appropriate type of pill.
[0014] In one embodiment of the pill verification system 120, the pill
verification system 120
also performs an analysis of the pills to determine the pill type. In this
embodiment, the pill
verification system 120 also receives the prescription information to
determine whether the pill type
matches the pharmaceutical composition stated on the prescription. The pill
verification system 120
may retrieve the prescription information from the pharmaceutical tracking
system, or may read a
barcode printed on the pill bottle label, or obtain the desired pill type
another way.
[0015] Using the desired pill type determined from the prescription
information, the pill
verification system 120 in this embodiment performs an automated verification
of the pills. Pill
verification methods are described in U.S. Patent App. No. 61/589,750, and PCT
App.
PCT/US2013/022754. To determine a pill type, the pill verification system 120
analyzes each
image of the pill to determine a feature vector including features describing
the pill, such as color,
shape, imprints on the pill, and other aspects of the pill. The pill
verification system 120 processes
the feature vectors using at least one classifier trained on a database of
pill images and associated
pill types. As a result of the classification, the pill verification system
120 determines a pill type for
the pill and whether the pill type matches the prescription information,
including whether it is the
correct type of pill and whether it is the correct dosage as stated in the
prescription information.
Thus, the verification information 140 may include a pill verification
indicating whether the pill
verification system 120 identified the pill images as consistent with the
prescription information. In
one embodiment, the pill verification system 120 provides verification
information 140 that includes
a group of images (e.g., four images) for each pill, along with a
determination of a pill type and
whether the pill type matches the prescription. The verification information
140 may also include a
quantity of pills in the pill vial.
4
CA 02920349 2016-02-03
WO 2015/021442 PCT/US2014/050440
[0016] In another embodiment, the pill verification system 120 provides the
pill
verification determined by the pill verification system 120 as the
verification information,
which may not include any pill images. In this embodiment, the pill
verification system 120
may verify the type of pill using pill images as described above, or may
verify the pill type
using another suitable technique.
[0017] In addition to the verification information 140, the pill
verification system 120 in
one embodiment also receives label information 130 identifying the labeling on
the pill vial.
To identify the label on the pill vial, the pill vial and the label on the
pill vial are also
captured as an image in one embodiment. A pill vial imaging system captures an
image of
the pill vial with the label applied to the pill vial. In other embodiments,
the label may be
captured separately from the pill vial, or the pill vial label may be
automatically generated
based on the prescription information. The pill vial image is captured in one
embodiment to
generate a circular "landscape" view of the pill vial, such that the entire
exterior of the pill
vial may be viewed. In one embodiment, the landscape view is captured by
multiple cameras
placed around the pill vial. In this embodiment, the pill vial imaging system
combines the
images from the multiple cameras into a single landscape image. In one
embodiment, rather
than the pill vial image, the label information is a label to be printed and
affixed to the pill
vial.
[0018] In one embodiment, the pill vial imaging system provides a label
verification from
a label verification system. The label verification system may determine the
verification of
the label using, e.g., character recognition of textual characters on the
pill, and analyze the
characters to verify that the label on the vial matches the prescription. The
label verification
may be included with the label information 130. It may be preferred to capture
the pill vial
image of the actual pill vial, so that after verification of the pills, the
pills may simply be
added to the appropriate (already verified) vial and sealed. In another
embodiment, the pill
vial is labeled and filled with the pills that were imaged by the pill
verification system 120.
In this embodiment, after verification of the pills and the pill vial, the
pill vial can be
immediately sealed after verification by the remote pharmacist, either by a
pharmacist
technician or by an automated mechanism.
[0019] To verify the contents of the pill vial and determine that the
prescription 100
ordered by the medical practitioner is appropriately filled, one or more of
the prescription
100, the pill verification information 140, and the label information 130 are
transmitted to a
remote verification system 150 for a pharmacist to review. The pill
verification system 120
manages this workflow and process in one embodiment.
CA 02920349 2016-02-03
WO 2015/021442
PCT/US2014/050440
[0020] Fig. 3 shows an embodiment of a pill verification system 120
separate from the
pill imaging and pill vial imaging systems. The pill verification system 120
shown in this
embodiment is a separate computing system from the pill imaging system and is
a computer
system which receives and processes pill verification information. The
verification system
120 receives the prescription information, pill verification information 140
and label
information 130 and transmits this package to the remote verification system
150 to display
for pharmacist review. A pill imaging system 300 captures images of pills to
provide pill
verification information 140 to pill verification system 120. The pill images
captured by pill
imaging system 300 may include several images of individual pills to be added
to a pill vial,
as described above, and may also perform pill verification of the pills. This
verification
information 140 is transmitted from the pill imaging system 300 to the pill
verification
system 120. Similarly, the pill vial imaging system 310 obtains label
information by
capturing an image of the pill vial or otherwise identifying information about
the label to be
added to the pill vial for the prescription. The pill verification system 120
also receives the
prescription information from prescription management system 320, which may
include an
image of the prescription 100.
[0021] Pill verification system 120 transmits the information used for pill
verification by
a pharmacist via a network 330 to remote verification system 150. Such
information in one
embodiment include the prescription, verification information associated with
the pills (e.g.,
pill images), and label information (e.g., a label image). The remote
verification system 150
displays the information to a remote pharmacist, who accepts or rejects the
filled
prescription.
[0022] The remote verification system 150 displays information for a
pharmacist to
verify a filled prescription. The remote verification system 150 is a
computing system that
includes a display and is configured to receive pill information, display the
information, and
transmit verification results input by a pharmacist to the pill verification
system 120 at the
pharmacy. The remote verification system 150 may be a display controlled
remotely by the
pill verification system 120, or may include a separate computing system with
a processor
and other computing components for receiving pill information and displaying
it to a
pharmacist. The remote verification system 150 receives the information
transmitted by the
pill verification system 120 and manages the presentation of that information
to a pharmacist
for verification. The remote verification system and display of information to
the pharmacist
is further described with respect to Fig. 2.
[0023] Fig. 4 shows components of a verification system 120 according to
one
embodiment. In this embodiment, the verification system 120 includes a
prescription
6
CA 02920349 2016-02-03
WO 2015/021442 PCT/US2014/050440
management module 400 that receives prescription information from the
prescription
management system 320, a pill vial imaging module 420 that receives pill vial
information
from the pill vial imaging system 310, and a pill imaging module 410 that
receives pill
verification information from pill imaging system 300. A prescription
verification module
430 collects the data received from each of these modules and transmits the
information to
the remote verification system 150 for display to the pharmacist for
verification. The
prescription verification module 430 receives a verification result from the
remote
verification system 150 and displays the verification result to an operator of
the pill
verification system 120.
100241 In one embodiment, the pill imaging system 300 is incorporated into
the pill
verification system 120. In additional embodiments, the pill verification
system 120
maintains the pill vial during the verification process, such that the pill
verification system
120 displays the results of the verification to the pharmacy technician or
other user who is
filling the prescription prior to removal of the pill vial from the pill
verification system 120.
[0025] In one embodiment, the pill verification system 120, pill vial
imaging system 310,
and pill imaging system 300 are incorporated into a single unit. In one
example of this
embodiment, the pill verification system 120 receives the pill vial in a pill
vial holder and
separately receives the pills to fill the prescription. The pills are passed
through a pill
imager, which captures images of the pills, and added to the pill vial. The
pill vial imaging
system captures images of the pill vial before, during, or after the pill vial
is filled with the
pills exiting the pill imager. The pill verification information is
transmitted to a display for
pharmacist review while the pill vial is held in the pill vial holder. In this
embodiment, the
pill vial holder may be configured to retain the pill vial until the
verification is received from
the remote pharmaceutical system.
[0026] Fig. 2 shows a display for pharmacist review of the filled
prescription order
according to one embodiment. The display for pharmacist review is located
remotely to a
location where the pills are selected for the pill vial and where the vial is
labeled (e.g., the
pharmacy). The display includes sufficient information for the pharmacist to
verify that the
prescription does not include errors without requiring the pharmacist to
personally oversee
the filled prescription and as a result. This does not require the personal
time of a pharmacist
to review prescriptions, and permits greater throughput from a pharmacy. In
addition, the
display may include a queue of prescriptions to be verified by the pharmacist,
which may be
prescriptions from many different pharmacies and pill verification systems
120.
[0027] In other embodiments, the display for pharmacist review is located
near the
location where the pills are selected and the vial is labeled. For example,
the remote
7
CA 02920349 2016-02-03
WO 2015/021442 PCT/US2014/050440
verification system may also be implemented in any situation where the
pharmacist does not
personally oversee the filled prescription, including a pharmacist verifying
the prescription
from a separate counter or room at a pharmacy.
[0028] As shown in the user interface displayed in Fig. 2, the interface
for pharmacist
review may include several panels displaying information about the filled
prescription. The
particular layout shown in Fig. 2 is an example, and other configurations may
also be used.
In addition, the display may not include all of the components illustrated in
Fig. 2, or
additional components based on the information provided by the pill
verification system 120.
The pharmacist is presented with the prescription 200, which may include an
image of a
hand-written prescription, or an electronic prescription, such as entered at a
prescription
management system 320. The pharmacist may review the prescription 200 to
verify that the
verification information about the pills and the label information is correct.
The display also
includes a pill vial image 210. The pill vial image 210 displays the label
information
indicating the instructions and contents of the pill vial as described by the
label on the pill
vial. This permits the pharmacist to verify the prescription has accurately
been transcribed
from the prescription 200 to the pill vial and that the instructions for the
customer (as printed
on the vial) are correct.
[0029] In the embodiment shown in Fig. 2, the pill verification information
includes a pill
verification indication 220 that the pill verification system 120 matched the
pill type of the
pills to the desired pills of the prescription. In this embodiment, the
verification information
includes pill images from the pill imaging process and a pill verification
from automated
analysis of the pill images. A pill image gallery 230 is also shown to the
pharmacist. The
pharmacist may review the gallery of pill images to verify that individual
pills imaged by the
pill verification system 120 match the characteristics in size, color, shape,
imprint, and other
features of the pharmaceutical composition that was prescribed (or in the case
of a
replacement generic, of the replacement generic). In some embodiments, the
pharmacist has
access to images of all of the pills or substantially all of the pills in the
vial. In other
embodiments, the pharmacist has access to images of at least 50%, 60%, 70%,
80%, 90%,
95%, 99% or other percentages of the pills in the vial. When there are any
errors in the pill
type identified by the pill verification system 120 (i.e., the identified pill
type does not match
the expected pill type), any pill that did not match may be highlighted in the
gallery 230 for
quick identification and review by the pharmacist. After reviewing the pill
verification
information, the pharmacist provides a verification result on an interface 240
whether the
prescription is properly filled. In one embodiment, such as when the pill
verification
8
CA 02920349 2016-02-03
WO 2015/021442 PCT/US2014/050440
information does not include pill images, the display provides the pill
verification indication
220 without the corresponding pill image gallery 230.
[0030] Using this method, the pharmacist is presented with sufficient
information to
quickly and easily verify the proper filling of a prescription. The pill
verification information
enables the pharmacist to review information relating to each of the pills
added to the pill
vial. When the pill type matching is available, the pharmacist gains comfort
that the pill has
been verified by the pill verification system, and when pill images are
available, the pills can
be quickly reviewed by the pharmacist using the images of the pill in the
gallery 230, in
particular any errors identified by the pill verification system 120. With
this system and
corresponding workflow, a pharmacist at a central location can review and
verify pills from a
large number of satellite pharmacies while maintaining high confidence of
faithfully
dispensing prescriptions. In addition, a pill verification system that
incorporates a pill
imaging and verification system can incorporate the pharmacist's verification
in its displayed
results, providing additional confidence in the displayed verification
results.
[0031] In alternate embodiment of the remote pill verification, rather than
a pharmacist
performing the remote verification, the pills are automatically verified by
another system
remote from the location where prescriptions are filled. Thus, the data
received from a local
pharmacy may be presented via an interface to a pharmaceutical validation
system rather than
a human pharmacist. The interface in one example is an application programming
interface
(API) to another application located at the remote pharmacist system. The
pharmaceutical
validation system determines whether the provided prescription information,
validation
information, and label information is acceptable and this response is
transmitted back to the
local pharmacy.
Summary
[0032] The foregoing description of the embodiments of the invention has
been presented
for the purpose of illustration; it is not intended to be exhaustive or to
limit the invention to
the precise forms disclosed. Persons skilled in the relevant art can
appreciate that many
modifications and variations are possible in light of the above disclosure.
[0033] Some portions of this description describe the embodiments of the
invention in
terms of algorithms and symbolic representations of operations on information.
These
algorithmic descriptions and representations are commonly used by those
skilled in the data
processing arts to convey the substance of their work effectively to others
skilled in the art.
These operations, while described functionally, computationally, or logically,
are understood
to be implemented by computer programs or equivalent electrical circuits,
microcode, or the
9
CA 2920349 2017-04-18
like. Furthermore, it has also proven convenient at times, to refer to these
arrangements of
operations as modules, without loss of generality. The described operations
and their associated
modules may be embodied in software, firmware, hardware, or any combinations
thereof.
[0034] Any of the steps, operations, or processes described herein may be
performed or
implemented with one or more hardware or software modules, alone or in
combination with
other devices. In one embodiment, a software module is implemented with a
computer program
product comprising a computer-readable medium containing computer program
code, which can
be executed by a computer processor for performing any or all of the steps,
operations, or
processes described.
[0035] Embodiments of the invention may also relate to an apparatus for
performing the
operations herein. This apparatus may be specially constructed for the
required purposes, and/or
it may comprise a general-purpose computing device selectively activated or
reconfigured by a
computer program stored in the computer. Such a computer program may be stored
in a
non-transitory, tangible computer readable storage medium, or any type of
media suitable for
storing electronic instructions, which may be coupled to a computer system
bus. Furthermore,
any computing systems referred to in the specification may include a single
processor or may be
architectures employing multiple processor designs for increased computing
capability.
[0036] Embodiments of the invention may also relate to a product that is
produced by a
computing process described herein. Such a product may comprise information
resulting from a
computing process, where the information is stored on a non-transitory,
tangible computer
readable storage medium and may include any embodiment of a computer program
product or
other data combination described herein.
[0037] Finally, the language used in the specification has been principally
selected for
readability and instructional purposes, and it may not have been selected to
delineate or
circumscribe the inventive subject matter. Accordingly, the disclosure of the
embodiments of the
invention is intended to be illustrative, but not limiting, of the scope of
the invention, which is set
forth in the following claims.
